Health in urban late medieval North-West Europe: a bioarchaeological study of Caen, Canterbury and Ghent

Abstract

Over half of the global population currently lives in an urban environment and this is still increasing rapidly in developing countries. This thesis aims to provide a comparative picture of health in the rapidly developing urban centres in late medieval NW Europe - here defined as northern France, England and Belgium - through bioarchaeological analysis. This study focused on macroscopic methods and “stress indicators” (cribra orbitalia, dental enamel hypoplasia, adult stature and periosteal reaction on the tibiae) as a proxy for health and sanitation in these populations and respiratory disease (periosteal rib lesions and maxillary sinusitis) as a proxy for air quality.
A 100 adult skeletons were analysed from the Darnétal cemetery of Caen (12th – 18th century AD), northern France, which had a reputation for poor sanitation. A further 100 adult skeletons were analysed from the cemetery of St. Gregory’s priory in Canterbury (12th – 16th century AD), whose economy is based around entertaining pilgrims and travellers. Lastly, The St. Pieter parish in Ghent (12th – 18th century AD) occupies a unique position on the edge of the town and 83 adult skeletons were analysed from this site.
The skeletal evidence did not reflect the differences in sanitary conditions expected originally. Similar results were recorded for average adult stature estimates as well as the prevalence of cribra orbitalia, and dental enamel hypoplasia across the sites. It has been suggested that urban centres throughout the region may have been challenged to provide a healthy living environment.
High prevalence rates of maxillary sinisusitis (Caen: 71%, Canterbury: 64%, and Ghent: 61%) and high prevalence rates of periosteal reaction on the ribs in Caen (63%) and Canterbury (63%) suggest significant levels of air pollution in these populations. The unusually high levels of rib lesions in Caen and Canterbury set the agenda for further research into their occurence and the development of recording standards.
Lastly, the historical differences between the towns, and the location of the St Pieter parish, challenge the simplistic division of settlements into ‘urban’ and ‘rural’ types. It reveals the perspective for a more nuanced interpretation of urbanisation in NW Europe.